Eastern Sports Medicine and Spine Associates LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

EASTERN SPORTS MEDICINE AND SPINE ASSOCIATES LLC

Practice address

701 Cottage Grove Road
E230
Bloomfield, CT 06002

Phone

(860) 648-0814

NPI assigned

Jul 29, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cheryl Flanagan

Title

Credentialer

Phone

(860) 282-4133

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth R Alleyne, MD

  • Orthopaedic Surgery Physician
  • South Windsor, CT
  • NPI 1316991136
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1003224569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 E RIVER DR",
            "address_2": "5TH FLOOR",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083288",
            "telephone_number": "860-282-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 COTTAGE GROVE ROAD",
            "address_2": "E230",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "06002",
            "telephone_number": "860-648-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SPORTS MEDICINE AND SPINE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-29",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "FLANAGAN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CREDENTIALER",
        "authorized_official_telephone_number": "860-282-4133"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Bloomfield, CT
• Providers in Bloomfield, CT by specialty
• Orthopaedic Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.